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A revolutionary reexamination of trauma’s role in the life journey, opening the door to growth and healing
Trauma does not just happen to a few unlucky people; it is the bedrock of our psychology. Death and illness touch us all, but even the everyday sufferings of loneliness and fear are traumatic. In The Trauma of Everyday Life renowned psychiatrist and author of Thoughts Without a Thinker Mark Epstein uncovers the transformational potential of trauma, revealing how it can be used for the mind’s own development.
Western psychology teaches that if we understand the cause of trauma, we might move past it while many drawn to Eastern practices see meditation as a means of rising above, or distancing themselves from, their most difficult emotions. Both, Epstein argues, fail to recognize that trauma is an indivisible part of life and can be used as a lever for growth and an ever deeper understanding of change. When we regard trauma with this perspective, understanding that suffering is universal and without logic, our pain connects us to the world on a more fundamental level. The way out of pain is through it.
Epstein’s discovery begins in his analysis of the life of Buddha, looking to how the death of his mother informed his path and teachings. The Buddha’s spiritual journey can be read as an expression of primitive agony grounded in childhood trauma. Yet the Buddha’s story is only one of many in The Trauma of Everyday Life. Here, Epstein looks to his own experience, that of his patients, and of the many fellow sojourners and teachers he encounters as a psychiatrist and Buddhist. They are alike only in that they share in trauma, large and small, as all of us do. Epstein finds throughout that trauma, if it doesn’t destroy us, wakes us up to both our minds’ own capacity and to the suffering of others. It makes us more human, caring, and wise. It can be our greatest teacher, our freedom itself, and it is available to all of us.
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MARK EPSTEIN, MD, is a psychiatrist in private practice in New York City and the author of a number of books about the interface of Buddhism and psychotherapy, including Thoughts Without a Thinker and Psychotherapy Without the Self. He received his undergraduate and medical degrees from Harvard University.
Except in the case of well-known figures introduced by first and last names, I have changed names and other identifying details or constructed composites in order to protect privacy.
The Way Out Is Through
For the first ten years of my work as a psychiatrist, I did not think much about trauma. I was in my thirties, and many of the people I worked with were not much older than I was. In the first flush of my marriage, most of my efforts were directed toward helping my patients find and achieve the kind of love and intimacy they wanted and deserved. In retrospect, I should have been alerted to the ubiquity of trauma by the fact that three of the first patients I ever cared for were young women on an inpatient psychiatric ward who each attempted suicide after breaking up with their boyfriends. Their experiences were all similar. The stability and security they were counting on suddenly vanished. The earth moved and their worlds collapsed. While I helped them to recover, it took me many more years to understand that their reactions were far from unique. They were impulsive, young, vulnerable, and full of unrealistic expectations, but they were being forced to deal with an uncomfortable truth that we all have to face in one form or another. Trauma is an indivisible part of human existence. It takes many forms but spares no one.
Ten years into my therapy practice, three women in their early thirties came to see me within three months of one another. Each of their husbands had dropped dead. One left in the morning to ride his mountain bike and had a heart attack, one lay stricken on the tennis court, and one did not wake up in the morning. Each of these women’s losses challenged my therapeutic approach. They had already found the love and intimacy I was endeavoring to help my patients achieve. They needed something else from me.
Around this same time, one of my long-term patients, a man about my own age, received a frightening diagnosis. He had a condition that threatened his life but that was known to have a highly variable course, discovered in a routine blood test. He might be severely sick soon, with a bone marrow cancer called multiple myeloma, or he might be fine for a long while. Only time, and careful monitoring, would tell. When he first told me, I reacted with genuine concern and barely disguised horror. He responded to my concern with alarm.
“I don’t need sympathy from you,” he said. “I can get that from other people. I need something different from you. This diagnosis is a fact, is it not? I can’t treat it like a tragedy. That’s why I’m coming to you. I know you understand that.”
My patient’s comment brought me up short. I knew he was right. His condition was mirroring the breakups, losses, and deaths that had been knocking at my door. His query, “This illness is a fact, is it not?” rang in my ears. What could I offer him? Already deeply influenced by the philosophy and psychology of Buddhism, I turned to it again for help. What I found did not really surprise me—in some sense I knew it already—but it helped me, and my patient, a great deal. In its most succinct form, it was what the Buddha called Realistic View. In the prescription for the end of suffering that he outlined in his Four Noble Truths, Realistic View held an important place. A critical component of what became known as the Noble Eightfold Path, Realistic View counseled that trauma, in any of its forms, is not a failure or a mistake. It is not something to be ashamed of, not a sign of weakness, and not a reflection of inner failing. It is simply a fact of life.
This attitude toward trauma is at the heart of the Buddha’s teaching, although it is often overlooked in the rush to embrace the inner peace that his teachings also promised. But inner peace is actually predicated upon a realistic approach to the uncertainties and fears that pervade our lives. Western psychology often teaches that if we understand the cause of a given trauma we can move past it, returning to the steady state we imagine is normal. Many who are drawn to Eastern practices hope that they can achieve their own steady state. They use religious techniques to quiet their minds in the hope of rising above the intolerable feelings that life evokes. Both strategies, at their core, seek to escape from trauma, once and for all. But trauma is all pervasive. It does not go away. It continues to reassert itself as life unfolds. The Buddha taught that a realistic view makes all the difference. If one can treat trauma as a fact and not as a failing, one has the chance to learn from the inevitable slings and arrows that come one’s way. Meditation makes profound use of this philosophy, but its utility is not limited to meditation. As my patient realized when grappling with his diagnosis, the traumas of everyday life, if they do not destroy us, become bearable, even illuminating, when we learn to relate to them differently.
When I first came upon the Buddha’s teachings, I was young and not really thinking about illness or death. No one I knew had died, and I was struggling with my own issues of adolescence and young adulthood. Trauma, in the sense of confronting an actual or threatened death or serious injury (as the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders defines “trauma”), was not something I had to face directly. But there was another kind of trauma, developmental trauma, percolating under the surface of my experience. Developmental trauma occurs when “emotional pain cannot find a relational home in which it can be held.”1 In retrospect, I can see that this was the case for me. In my first encounters with Buddhism, I was trying to escape from emotional pain I did not really understand. But in order to practice the Buddha’s teachings, I needed a realistic view. This meant accepting there was no escape. The most important spiritual experiences of my early exploration of Buddhism gave me such a view, although I have had to be reminded of it time and again as circumstances have evolved. This is what I remembered in response to my patient’s plea, however. What I learned in grappling with my own trauma was relevant in his struggle, too.
I could tell, when I first came upon Buddhism, that there was going to be a problem getting it right. There were too many paradoxes for there not to be. Self appears but does not truly exist, taught the Buddha. Change your thoughts but remain as you are, said the Dalai Lama. The mind that does not understand is the Buddha; there is no other, wrote the Zen philosopher D. T. Suzuki. I was excited by these teachings—they rang true in some ill-defined way—but it was not easy to make the transition from conceptual appreciation to experiential understanding. Nor could I even say with confidence that I truly understood things conceptually. At the time of my introduction to Buddhism, I was still a college student and I was good at only one thing: studying. I knew how to write a paper, prepare for a test, gather information, and analyze it a little bit. I had figured out how to be reasonably comfortable in an academic environment, but I was after something more, although I found it difficult to put my finger on just what that might be.
Whenever I tried to put it into words it sounded banal. While comfortable in my academic world, I was uncomfortable with myself. Deep down, I felt unsure. Not of my intellectual skills but of something more amorphous. I could frame it in terms of existential anxiety or even adolescent ennui, but it felt more personal than that. I worried there was something wrong with me, and I longed to feel more at ease. I had the sense that I was living on the surface of myself, that I was keeping myself more two-dimensional than I really was, that I was inhibited, or was inhibiting myself, in some ill-defined way. I felt boring, although I framed it in terms of feeling empty. To admit that I felt boring would have made me feel too ashamed.
Buddhism appealed to me because, while it hinged on paradox, it also seemed very logical. It spoke directly to my feelings of anxiety and even promised that there was something concrete to do about them. The Buddha, in his First Noble Truth, affirmed my experience by invoking dukkha, or suffering, as a basic fact of life. He spoke about it very psychologically; he even specified that there was something uncomfortable about the self in particular, some way that it could not help but disappoint. This made me feel relieved, as if to suggest that I was not making it up. If the Buddha had noticed it all those years ago, maybe it was not just my problem; maybe there was even something to do about it.
The first words of the Buddha that I ever read, preserved in a collection called the Dhammapada, reinforced my feeling of hopefulness by speaking directly to my helplessness. He seemed to be describing my own mind.
Flapping like a fish thrown on dry ground, it trembles all day, struggling.
I liked the image of the fish on dry ground. It spoke of my discomfort, of what I would now call a feeling of estrangement, a sense of not being at peace, or at one, with myself. And it caught the feeling of my anxiety perfectly. But there was more than just a diagnosis of the problem in the Buddha’s approach. There was a science to it that I found reassuring, an inner science.
Like an archer an arrow,
the wise man steadies his trembling mind,
a fickle and restless weapon.
The Buddha had a solution, something to do for the problem, a way of working directly with the mind that appealed to the budding therapist in me. There was a path with a goal and a concrete method that one could practice in order to feel better.
The mind is restless.
To control it is good.
A disciplined mind is the road to Nirvana.2
I was excited by the promise of the Buddha’s psychology, drawn to it before ever learning much about Western therapy. I could see that my mind needed work, and the Buddha’s prescription of self-investigation and mental discipline, what he called “mindfulness and clear comprehension,” made intuitive sense to me. Yet the more I learned about meditation the clearer it became that there was a limit to how far I could think, or reason, or even practice my way in. I wanted to understand and master it, but it frustrated me when I approached it. Whenever I sat down to meditate, my own insecurities rose to the surface. I was never sure if I was doing it right.
I have written of how my first understanding of meditation came from learning to juggle. I was at a Buddhist summer institute in Colorado in the summer after my junior year in college. The faculty was full of Buddhist teachers: university professors, Tibetan lamas, Zen roshis, American Peace Corps veterans in the process of becoming meditation teachers. I took classes from all of them, but my roommates, randomly assigned to me for the summer months, stopped going to class after a week or two, turned off by the pretension of many of the most popular instructors. They watched me laboring at meditation and after some time took pity on me. One day, they offered to teach me to juggle.
I was up for the challenge and worked at it assiduously. After several days of practice, I succeeded at keeping three balls in the air. My mind relaxed and I momentarily stopped worrying about keeping everything together. A new kind of space opened up in which everything flowed in its own way and I settled into it. I was present but not in the way, attentive and physically active but not interfering, detached but not disinterested, watching but at the same time completely involved. My familiar and troubled self did not disappear; it became one more thing to be aware of, one of the balls I was juggling. Instead of secretly fighting with it in the back of my mind, I became more accepting of my troubling inner feelings. I sensed a shift in my basic orientation to life, an easing of my self-centeredness, more of an ability to take myself lightly.
I also found that it was possible to maintain this new frame of mind, both when I was juggling and, sometimes, when I was not. If I kept a light and steady touch on my mind, something of the juggling remained with me. If I tried too hard, thought about it too much, or, conversely, relaxed altogether, the balls fell out of the air. But if I dropped all that and just juggled, it seemed to take care of itself. Juggling and, by implication, meditation required that I suspend my usual orientation and enter some new territory, an intermediate zone that seemed to create something new or evoke something old. My hands were not only juggling the balls; they were juggling my mind. Or maybe my mind was doing the juggling, not my hands. And where was “I,” the troubled and anxious “me,” the one who was worried about being good enough, in this process? I really could not say. Intrigued and, for the moment, relieved, I returned to my meditation classes. I had a new way to approach meditation now, and a new orientation to myself.
I began to appreciate that Buddhism demanded something more of me than studying and also something more than just rote practice. Not that it did not engage my intellect—it did. And not that it did not encourage conceptual rigor and rigorous effort—these were things I appreciated about it. But it demanded something in addition. I knew nothing of art at this time, but I can see now that Buddhism is as much inner art as it is inner science. It is a formless art, to be sure—the only product is the self, and even that comes quickly into continuous question—but it is an art nonetheless, one that demands its own touch, one I could only understand to the extent that I could give myself over to it completely. This emphasis on surrender and process was not one that I knew before I came upon Buddhism—perhaps if I had been a musician or an actor or a painter or a poet, it would not have seemed like such a revelation—but for me it was like stumbling into a new reality, one in which I was suddenly being asked to give of myself in a new way. In Zen, the image of falling backward into a well is used to describe what it is like. For me it was like feeling my way into myself while blindfolded, never quite sure what I would find.
Feeling my way into myself. That was definitely what it was like. Feeling my way into all of the doubts and anxieties and insecurities and dis-ease that I would have been all too happy to get rid of, that I had initially hoped meditation would destroy. Feeling my way into them, in my body as well as in my mind, and feeling my way through them. Something changed as I embraced the art of meditation. Instead of approaching myself with dread, with the secret hope that I could rise above my personal struggles, I began to explore the texture of my own suffering. No one had ever told me such a thing was possible. Even as I practiced under the tutelage of a new generation of Buddhist teachers, I had trouble reconciling my experience with what I was learning from my Buddhist books. The fundamental psychological teaching of the Buddha was called anatman (in Sanskrit) or anatta (in Pali, the language of the Buddhist scriptures, a Sanskrit-related tong...
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